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HIV/AIDS Epidemiology Research

Highly active antiretroviral therapy (HAART) has been resoundingly successful at reducing morbidity and mortality for patients infected with HIV. Yet, major challenges remain in identifying those who do not know they are infected, engaging them in care, preventing transmission to others, and improving quality of life for those living with HIV. Epidemiologic tools are essential to understanding patterns of risk and transmission, finding individuals and groups that need better access to care, and identifying key methods for interruption of transmission and control of the epidemic at the population level.

For people living with HIV/AIDS, research on the clinical management of co-morbidities, improvement of quality of life, and secondary prevention strategies are important research priorities. Using epidemiological methods, NIAID-supported investigators are able to address key scientific questions by studying and comparing transmission of HIV and consequences of infection in different human populations. Scientific findings gathered from these epidemiological studies provide insight for developing HIV prevention strategies and interventions that can improve clinical outcomes and quality of life for those infected.

Research has confirmed that early treatment is beneficial to the HIV-infected individual and that treating them also substantially lowers their risk of transmitting the virus to others. This double benefit of therapy makes it even more imperative to increase the rate at which persons infected with HIV are identified, linked to care, treated, and retained in care to maintain viral suppression. NIAID is committed to reducing HIV infection in high-risk domestic communities of young men who have sex with men (MSM) and minority women and to anticipate new at-risk communities such as those with high levels of injection drug use. NIAID supports research across the spectrum of epidemiology to realize these goals. In addition, NIAID remains committed to evaluating the HIV epidemic globally and to strengthening the capacity to achieve the World Health Organization goals of 90 percent tested, 90 percent on treatment, 90 percent virally suppressed by 2020.

Furthermore, as people living with HIV continue to live longer, many of them may experience other serious or life-threatening co-morbidities, such as heart disease or cancer, at a higher rate or younger age than their uninfected peers. There may also be different ways for how diseases occurs in HIV-infected persons. NIAID partners with other institutes and centers at the National Institutes of Health and grantees to seek answers on the long-term clinical picture of treated HIV including novel methods in epidemiology to monitor disease outcomes.

Goals and Activities

  • Improve surveillance of HIV transmission dynamics including big data and phylogenetic methods to rapidly identify the populations affected by HIV, determine the rate at which new infections are occurring, and characterize transmission network
  • Use epidemiologic methods that capitalize on the advent of patient-driven medicine and mobile health monitoring devices for collecting data at the individual level
  • Improve our knowledge of key populations at high risk of HIV infection, such as MSM, people who inject drugs, and sex workers, to identify interventions to reduce HIV acquisition risk and improve clinical outcomes
  • Understand the epidemiology of the individual and contextual factors which place individuals and communities at risk for poor clinical outcomes along the treatment cascade, which may include observational or interventional research, implementation science or clinical trials, and structural and/or biomedical approaches to ameliorate these risk factors
  • Evaluate the patterns of adherence to HAART in populations around the world, key predictors of disease progression, and the efficacy of HAART in populations exposed to a variety of factors such as other infections and under nutritional and other health stressors
  • Elucidate the mechanism of HIV disease and immune system inflammation in different organ systems
  • Study the biological, clinical, and epidemiological characteristics of people who are at high risk for HIV infection but do not become infected (e.g., long-term non-progressors)

Additional Information

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Last Updated July 31, 2015